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目的:比较快速急诊内科评分(REMS)及改良早期预警评分(MEWS)对重症中暑患者预后的预测价值,探讨更适合判断重症中暑患者病情的评分方法。方法:对34例重症中暑患者临床资料进行回顾性分析,分别比较存活及死亡患者入院RMES和MEWS差异,并通过受试者工作特征曲线(ROC曲线)对比两种评分对重症中暑患者预后判断的准确性。结果:存活及死亡患者入院REMS分值分别为5.15±3.21、7.88±3.36,差异有统计学意义(P=0.046);MEWS分值分别为6.12±2.92、9.25±2.05,差异有统计学意义(P=0.008);REMS和MEWS对重症中暑患者预后判断的ROC曲线下面积分别为0.736(95%CI:0.529~0.942)和0.810(95%CI:0.646~0.974),差异无统计学意义。结论:REMS和MEWS均能较好的判断重症中暑患者的预后,其中MEWS评分灵敏度更高,更适用于急诊及院前高危重症中暑患者的早期识别和筛查。
OBJECTIVE: To compare the predictive value of REMS and MEWS in predicting the prognosis of patients with severe stroke, and to find a more suitable method for judging the severity of stroke in patients with severe stroke. Methods: The clinical data of 34 patients with severe stroke were retrospectively analyzed. The differences of survival and death were compared between RMES and MEWS. The receiver operating characteristic curve (ROC curve) was used to compare the prognosis of severe heat stroke patients accuracy. Results: The REMS scores of surviving and dead patients were 5.15 ± 3.21 and 7.88 ± 3.36 respectively, with significant difference (P = 0.046); MEWS scores were 6.12 ± 2.92 and 9.25 ± 2.05, respectively, with significant difference P = 0.008). The area under the ROC curve of REMS and MEWS for patients with severe stroke was 0.736 (95% CI: 0.529-0.942) and 0.810 (95% CI: 0.646-0.974) respectively, with no significant difference. CONCLUSIONS: Both REMS and MEWS can better predict the prognosis of severe heat stroke patients. MEWS score is more sensitive and suitable for early identification and screening of patients with emergency and pre-hospital high-risk severe stroke.